Prison Hunger Strike Ends, Inmates' Health Still at Risk

After 59 days, California inmates have ended their hunger strike. The prisoners had been protesting what they called aggressive use of solitary confinement, which kept some prisoners in isolation for decades.

Some 30,000 inmates began the strike on July 8, but that number dropped over time. This week there were about 100 remaining, including 40 who have been on continuous hunger strike during the two-month period. Those on hunger strike were getting by on Gatorade, totaling 600-625 calories a day, and vitamins.

In addition, advocates say the men had put on extra pounds in anticipation of the hunger strike. Some may have weighed 225 to 250 pounds at the start of the strike; others likely weighed less.

While it does not appear that any of the inmates have suffered severe health problems that can result from starvation, the process of commencing eating again must be done slowly and carefully. Anyone who has refused food over a long period of time is at risk of "refeeding syndrome," which can cause "potentially fatal shifts" in fluids and electrolytes possibly leading to cardiac arrest and even death.

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Joyce Hayhoe, spokeswoman for the court-appointed federal receiver overseeing prison health care, says the Gatorade seems to have helped the inmates avoid significant health problems and hopes that the men will avoid other health problems during the refeeding phase.

But Andrea Garber, an expert on starvation with UC San Francisco Benioff Children’s Hospital, urged caution. "Nobody really knows. You have to assume that they are at just as high risk as they would have been without Gatorade."

The California Correctional Health Care System has established guidelines about safely beginning to eat again.

Specifically, on day 1 of refeeding, which would be Thursday, men could receive 5-10 calories per day per kilogram of body weight. So, a 158-pound man (or 72 kg) could receive up to 720 calories. The guidelines specify meals: breakfast would be 4 ounces nonfat milk, 2 ounces hot cereal, 1 ounce breakfast meat or eggs, 2 ounces juice.

Hayhoe stressed that each inmate would be treated individually and their individual diets will depend on their health status. Some of the men will do refeeding in their cells, while others will be medically monitored 24 hours a day.

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In the first several days of refeeding, calories are increased slowly, as long as the patient tolerates the food. Hayhoe estimated the refeeding process for this group of hunger strikers will take between four days to just over a week.

Garber said she found the guidelines "very cautious" and added, "It does sound like they are taking it seriously and proceeding with every caution."